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Sheinerman KS, Umansky S. Universal screening test based on analysis of circulating organ-enriched microRNAs: a novel approach to diagnostic screening. Expert Rev Mol Diagn 2014; 15:329-38. [PMID: 25354444 DOI: 10.1586/14737159.2014.973858] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Early disease detection leads to more effective and cost-efficient treatment. It is especially important for cancer and neurodegenerative diseases, because progression of these pathologies leads to significant and frequently irreversible changes in underlying pathophysiological processes. At the same time, the development of specific screening tests for detection of each of the hundreds of human pathologies in asymptomatic stage may be impractical. Here, we discuss a recently proposed concept: the development of minimally invasive Universal Screening Test (UST) based on analysis of organ-enriched microRNAs in plasma and other bodily fluids. The UST is designed to detect the presence of a pathology in particular organ systems, organs, tissues or cell types without diagnosing a specific disease. Once the pathology is detected, more specific, and if necessary invasive and expensive, tests can be administered to precisely define the nature of the disease. Here, we discuss recent studies and analyze the data supporting the UST approach.
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Jansen F, Yang X, Proebsting S, Hoelscher M, Przybilla D, Baumann K, Schmitz T, Dolf A, Endl E, Franklin BS, Sinning JM, Vasa-Nicotera M, Nickenig G, Werner N. MicroRNA expression in circulating microvesicles predicts cardiovascular events in patients with coronary artery disease. J Am Heart Assoc 2014; 3:e001249. [PMID: 25349183 PMCID: PMC4338711 DOI: 10.1161/jaha.114.001249] [Citation(s) in RCA: 246] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Circulating microRNAs (miRNAs) are differentially regulated and selectively packaged in microvesicles (MVs). We evaluated whether circulating vascular and endothelial miRNAs in patients with stable coronary artery disease have prognostic value for the occurrence of cardiovascular (CV) events. Methods and Results Ten miRNAs involved in the regulation of vascular performance—miR‐126, miR‐222, miR‐let7d, miR‐21, miR‐20a, miR‐27a, miR‐92a, miR‐17, miR‐130, and miR‐199a—were quantified in plasma and circulating MVs by reverse transcription polymerase chain reaction in 181 patients with stable coronary artery disease. The median duration of follow‐up for major adverse CV event–free survival was 6.1 years (range: 6.0–6.4 years). Events occurred in 55 patients (31.3%). There was no significant association between CV events and plasma level of the selected miRNAs. In contrast, increased expression of miR‐126 and miR‐199a in circulating MVs was significantly associated with a lower major adverse CV event rate. In univariate analysis, above‐median levels of miR‐126 in circulating MVs were predictors of major adverse CV event–free survival (hazard ratio: 0.485 [95% CI: 0.278 to 0.846]; P=0.007) and percutaneous coronary interventions (hazard ratio: 0.458 [95% CI: 0.222 to 0.945]; P=0.03). Likewise, an increased level of miR‐199a in circulating MVs was associated with a reduced risk of major adverse CV events (hazard ratio: 0.518 [95% CI: 0.299 to 0.898]; P=0.01) and revascularization (hazard ratio: 0.439 [95% CI: 0.232 to 0.832]; P=0.01) in univariate analysis. miRNA expression analysis in plasma compartments revealed that miR‐126 and miR‐199a are present mainly in circulating MVs. MV‐sorting experiments showed that endothelial cells and platelets were found to be the major cell sources of MVs containing miR‐126 and miR‐199a, respectively. Conclusion MVs containing miR‐126 and miR‐199a but not freely circulating miRNA expression predict the occurrence of CV events in patients with stable coronary artery disease.
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Affiliation(s)
- Felix Jansen
- Department of Internal Medicine II, Rheinische Friedrich-Wilhelms University, Bonn, Germany (F.J., S.P., M.H., D.P., K.B., T.S., J.M.S., M.V.N., G.N., N.W.)
| | - Xiaoyan Yang
- Feinberg Cardiovascular Research Institute, Northwestern University School of Medicine, Chicago, IL (X.Y.)
| | - Sebastian Proebsting
- Department of Internal Medicine II, Rheinische Friedrich-Wilhelms University, Bonn, Germany (F.J., S.P., M.H., D.P., K.B., T.S., J.M.S., M.V.N., G.N., N.W.)
| | - Marion Hoelscher
- Department of Internal Medicine II, Rheinische Friedrich-Wilhelms University, Bonn, Germany (F.J., S.P., M.H., D.P., K.B., T.S., J.M.S., M.V.N., G.N., N.W.)
| | - David Przybilla
- Department of Internal Medicine II, Rheinische Friedrich-Wilhelms University, Bonn, Germany (F.J., S.P., M.H., D.P., K.B., T.S., J.M.S., M.V.N., G.N., N.W.)
| | - Katharina Baumann
- Department of Internal Medicine II, Rheinische Friedrich-Wilhelms University, Bonn, Germany (F.J., S.P., M.H., D.P., K.B., T.S., J.M.S., M.V.N., G.N., N.W.)
| | - Theresa Schmitz
- Department of Internal Medicine II, Rheinische Friedrich-Wilhelms University, Bonn, Germany (F.J., S.P., M.H., D.P., K.B., T.S., J.M.S., M.V.N., G.N., N.W.)
| | - Andreas Dolf
- Institute of Molecular Medicine, Rheinische Friedrich-Wilhelms University, Bonn, Germany (A.D., E.E.)
| | - Elmar Endl
- Institute of Molecular Medicine, Rheinische Friedrich-Wilhelms University, Bonn, Germany (A.D., E.E.)
| | - Bernardo S Franklin
- Institute of Innate Immunity, Rheinische Friedrich-Wilhelms University, Bonn, Germany (B.S.F.)
| | - Jan-Malte Sinning
- Department of Internal Medicine II, Rheinische Friedrich-Wilhelms University, Bonn, Germany (F.J., S.P., M.H., D.P., K.B., T.S., J.M.S., M.V.N., G.N., N.W.)
| | - Mariuca Vasa-Nicotera
- Department of Internal Medicine II, Rheinische Friedrich-Wilhelms University, Bonn, Germany (F.J., S.P., M.H., D.P., K.B., T.S., J.M.S., M.V.N., G.N., N.W.)
| | - Georg Nickenig
- Department of Internal Medicine II, Rheinische Friedrich-Wilhelms University, Bonn, Germany (F.J., S.P., M.H., D.P., K.B., T.S., J.M.S., M.V.N., G.N., N.W.)
| | - Nikos Werner
- Department of Internal Medicine II, Rheinische Friedrich-Wilhelms University, Bonn, Germany (F.J., S.P., M.H., D.P., K.B., T.S., J.M.S., M.V.N., G.N., N.W.)
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304
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Duong Van Huyen JP, Tible M, Gay A, Guillemain R, Aubert O, Varnous S, Iserin F, Rouvier P, François A, Vernerey D, Loyer X, Leprince P, Empana JP, Bruneval P, Loupy A, Jouven X. MicroRNAs as non-invasive biomarkers of heart transplant rejection. Eur Heart J 2014; 35:3194-202. [PMID: 25176944 DOI: 10.1093/eurheartj/ehu346] [Citation(s) in RCA: 151] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIM Rejection is one of the major causes of late cardiac allograft failure and at present can only be diagnosed by invasive endomyocardial biopsies. We sought to determine whether microRNA profiling could serve as a non-invasive biomarker of cardiac allograft rejection. METHODS We included 113 heart transplant recipients from four referral French institutions (test cohort, n = 60, validation cohort, n = 53). In the test cohort, we compared patients with acute biopsy-proven allograft rejection (n = 30) to matched control patients without rejection (n = 30), by assessing microRNAs expression in the heart allograft tissue and patients concomitant serum using RNA extraction and qPCR analysis. Fourteen miRNAs were selected on the basis of their implication in allograft rejection, endothelial activation, and inflammation and tissue specificity. RESULTS We identified seven miRNAs that were differentially expressed between normal and rejecting heart allografts: miR-10a, miR-21, miR-31, miR-92a, miR-142-3p miR-155, and miR-451 (P < 0.0001 for all comparisons). Four out of seven miRNAs also showed differential serological expression (miR-10a, miR-31, miR-92a, and miR-155) with strong correlation with their tissular expression. The receiver-operating characteristic analysis showed that these four circulating miRNAs strongly discriminated patients with allograft rejection from patients without rejection: miR-10a (AUC = 0.975), miR-31 (AUC = 0.932), miR-92a (AUC = 0.989), and miR-155 (AUC = 0.998, P < 0.0001 for all comparisons). We confirmed in the external validation set that these four miRNAs highly discriminated patients with rejection from those without. The discrimination capability of the four miRNAs remained significant when stratified by rejection diagnosis (T-cell-mediated rejection or antibody-mediated rejection) and time post-transplant. CONCLUSION This study demonstrates that a differential expression of miRNA occurs in rejecting allograft patients, not only at the tissue level but also in the serum, suggesting their potential relevance as non-invasive biomarkers in heart transplant rejection.
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Affiliation(s)
- Jean-Paul Duong Van Huyen
- Paris Translational Research Center for Organ Transplantation, INSERM UMR 970, Biostatistics and Histopathology Platform, PARCC Cardiovascular Research Institute, Paris F-75015, France Université Sorbonne Paris Cité, France Department of Pathology, Necker Hospital, APHP, Paris F-75015, France
| | - Marion Tible
- Paris Translational Research Center for Organ Transplantation, INSERM UMR 970, Biostatistics and Histopathology Platform, PARCC Cardiovascular Research Institute, Paris F-75015, France Université Sorbonne Paris Cité, France
| | - Arnaud Gay
- Cardio-Thoracic Surgery Unit and Pathology Department, Rouen University Hospital, France
| | - Romain Guillemain
- Department of Pathology and Department of Cardiovascular Surgery, Hôpital Européen Georges Pompidou, APHP, Paris F-75015, France
| | - Olivier Aubert
- Paris Translational Research Center for Organ Transplantation, INSERM UMR 970, Biostatistics and Histopathology Platform, PARCC Cardiovascular Research Institute, Paris F-75015, France
| | - Shaida Varnous
- Cardio-Thoracic Surgery Unit and Pathology Department, La Pitié-Salpétrière, APHP, Paris F-75013, France
| | - Franck Iserin
- Departement of Cardiology, Necker Hospital, APHP, Paris F-75015, France
| | - Philippe Rouvier
- Cardio-Thoracic Surgery Unit and Pathology Department, La Pitié-Salpétrière, APHP, Paris F-75013, France
| | - Arnaud François
- Cardio-Thoracic Surgery Unit and Pathology Department, Rouen University Hospital, France
| | - Dewi Vernerey
- Paris Translational Research Center for Organ Transplantation, INSERM UMR 970, Biostatistics and Histopathology Platform, PARCC Cardiovascular Research Institute, Paris F-75015, France
| | - Xavier Loyer
- Paris Translational Research Center for Organ Transplantation, INSERM UMR 970, Biostatistics and Histopathology Platform, PARCC Cardiovascular Research Institute, Paris F-75015, France
| | - Pascal Leprince
- Cardio-Thoracic Surgery Unit and Pathology Department, La Pitié-Salpétrière, APHP, Paris F-75013, France
| | - Jean-Philippe Empana
- Paris Translational Research Center for Organ Transplantation, INSERM UMR 970, Biostatistics and Histopathology Platform, PARCC Cardiovascular Research Institute, Paris F-75015, France
| | - Patrick Bruneval
- Paris Translational Research Center for Organ Transplantation, INSERM UMR 970, Biostatistics and Histopathology Platform, PARCC Cardiovascular Research Institute, Paris F-75015, France Université Sorbonne Paris Cité, France Department of Pathology and Department of Cardiovascular Surgery, Hôpital Européen Georges Pompidou, APHP, Paris F-75015, France
| | - Alexandre Loupy
- Paris Translational Research Center for Organ Transplantation, INSERM UMR 970, Biostatistics and Histopathology Platform, PARCC Cardiovascular Research Institute, Paris F-75015, France Université Sorbonne Paris Cité, France
| | - Xavier Jouven
- Paris Translational Research Center for Organ Transplantation, INSERM UMR 970, Biostatistics and Histopathology Platform, PARCC Cardiovascular Research Institute, Paris F-75015, France Université Sorbonne Paris Cité, France
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